Provider Demographics
NPI:1366545816
Name:LOVELL, CYNTHIA JO (MED LPC)
Entity type:Individual
Prefix:MS
First Name:CYNTHIA
Middle Name:JO
Last Name:LOVELL
Suffix:
Gender:F
Credentials:MED LPC
Other - Prefix:
Other - First Name:CYNTHIA
Other - Middle Name:B
Other - Last Name:LOVELL
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MED LPC
Mailing Address - Street 1:8720 THUNDERBIRD LANE
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75238
Mailing Address - Country:US
Mailing Address - Phone:214-341-7787
Mailing Address - Fax:214-520-7579
Practice Address - Street 1:3710 RAWLINS STREET
Practice Address - Street 2:SUITE 1370
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75219
Practice Address - Country:US
Practice Address - Phone:214-520-7575
Practice Address - Fax:214-520-7579
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-07
Last Update Date:2009-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX11513101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional